Goal 6: Combating Disease

Epidemic diseases exact a huge toll in human suffering and lost opportunities for development.

Poverty, armed conflict, and natural disasters contribute to the spread of disease—and recovery, in turn, is often endangered by disease.

In Africa, AIDS has reversed decades of improvements in life expectancy and left millions of children orphaned.

By end-2006 an estimated 39.5 million people globally were living with HIV, up 2.4 million since 2004, and an estimated three million people had died from AIDS.

While the spread of AIDS has slowed in parts of Sub-Saharan Africa, it remains the center of the epidemic; home to just over 10 percent of the world’s people, 64 percent of all HIV-positive people, and 90 percent of all HIV-positive children.

About 60 percent of HIV-positive adults in Africa are women. The largest recent increases in the number of people with HIV have been in Eastern Europe, and Central and East Asia (21 percent higher in 2006 than in 2004).

Recent experience in combating the spread of AIDS has demonstrated three important messages: reversing its spread is possible, treatment is effective in the developing world, and prevention remains a crucial challenge.

More effective, evidence-based approaches to prevention are required—drawn from careful evaluation of what works in different contexts and the continued tailoring of responses to the changing epidemic.

Increasing the awareness of the impact of malaria and tuberculosis (TB) on human development has been matched with a commitment to fight these diseases, and fight them more effectively. There are an estimated 300–500 million new cases of malaria each year, leading to more than 1 million deaths.

Nearly all the cases and more than 95 percent of the deaths occur in Sub-Saharan Africa. TB strikes 9 million people each year and kills 2 million.

But there has been clear progress in reducing TB prevalence and deaths in recent years. The only region where TB incidence is still growing is Africa, because of the emergence of drug-resistant strains and the greatly reduced resistance to TB among people with HIV.

Impressive progress has been made in extending antiretroviral coverage in Sub-Saharan Africa, where the number of people receiving treatment has more than doubled since 2004.

While the number of people receiving antiretroviral therapy (ART) in East, South, and Southeast Asia has increased rapidly, progress in Europe and Central Asia and in North Africa and the Middle East has been less dramatic.

Nonetheless, antiretroviral treatment in the developing world still reaches just 24 percent of those who need it.

Many developing countries have successfully reduced tuberculosis prevalence since 1990. Sub-Saharan Africa is the only region where TB prevalence continues to increase; TB-related deaths reached 600,000 in 2004.